title: The Bedford Alzheimer nursing-severity scale to assess dementia severity in advanced dementia: a nonparametric item response analysis and a study of its psychometric characteristics.
abstract: The Bedford Alzheimer Nursing-Severity Scale (BANS-S) assesses disease severity in patients with advanced Alzheimer's disease. Since Alzheimer is a progressive disease, studying the hierarchy of the items in the scale can be useful to evaluate the progression of the disease. Data from 164 Alzheimer's patients and 186 patients with other dementia were analyzed using the Mokken Scaling Methodology to determine whether respondents can be ordered in the trait dementia severity, and to study whether an ordering between the items exist. The scalability of the scale was evaluated by the H coefficient. Results showed that the BANS-S is a reliable and medium scale (0.4≤H<0.5) for the Alzheimer group. All items with the exception of the item about mobility could be ordered. When later item was eliminated from the scale, the H coefficient decreased indicating that the scalability of the scale in the original form is more accurate than in the shorter version. For the other dementia group, the BANS-S did not fit any of the Mokken Scaling models because the scale was not unidimensional. In this group, a shorter version of the scale without the sleeping cycle item and the mobility item has better reliability and scalability properties than the original scale.
authors.affiliation: 1Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Francisca
authors.initials: F
authors.lastname: Galindo-Garre
authors.forename: Simone A
authors.initials: SA
authors.lastname: Hendriks
authors.forename: Ladislav
authors.initials: L
authors.lastname: Volicer
authors.forename: Martin
authors.initials: M
authors.lastname: Smalbrugge
authors.forename: Cees M P M
authors.initials: CM
authors.lastname: Hertogh
authors.forename: Jenny T
authors.initials: JT
authors.lastname: van der Steen
mesh_terms: D000203:Activities of Daily Living; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis* / Q000451:nursing; D003704:Dementia / Q000175:diagnosis / Q000451:nursing; D015140:Dementia, Vascular / Q000150:complications / Q000175:diagnosis* / Q000451:nursing; D006801:Humans; D011594:Psychometrics / Q000295:instrumentation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012890:Sleep; D012919:Social Behavior; D013060:Speech
keywords: Alzheimer’s disease; Bedford Alzheimer Nursing-Severity scale; Mokken scaling; item response theory